Once-Daily Atomoxetine for Treating Pediatric Attention-Deficit/Hyperactivity Disorder: Comparison of Morning and Evening Dosing
Abstract
In this 3-arm, randomized, double-blind trial, once-daily morning-dosed atomoxetine, evening-dosed atomoxetine, and placebo were compared for treating pediatric attention-deficit/hyperactivity disorder (ADHD). Patients received morning atomoxetine/evening placebo (n = 102), morning placebo/evening atomoxetine (n = 93), or morning placebo/evening placebo (n = 93) for about 6 weeks. Core symptom efficacy was measured at weeks 0, 1, 3, and 6. Parent assessments of the child’s home behaviors in the evening and early morning were collected daily during the first 2 weeks of treatment. Morning-dosed and evening-dosed atomoxetine significantly decreased core ADHD symptoms relative to placebo and produced symptom improvements that were measured up to 24 hours later. Morning dosing was superior to evening dosing on some efficacy measures. Evening dosing showed greater tolerability with significantly more patients receiving morning atomoxetine reporting at least 1 adverse event than those receiving evening atomoxetine.
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Dosing atomoxetine in the evening rather than in the morning reduces daytime somnolence.
“Dosing in the evening rather than in the morning has been found to reduce daytime somnolence with atomoxetine (Block et al. 2009).”
From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as Block et al. 2009
When atomoxetine is administered once daily, morning dosing may be more efficacious, but evening dosing may be more tolerable.
“When atomoxetine is administered once daily, some evidence suggests that morning dosing may be more efficacious, but evening dosing may be more tolerable [84].”
From Advances in understanding and treating ADHD (2011) · cites this paper as [84]
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Associations of sleep disturbance with ADHD: implications for treatment
Hvolby, A. (2015) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-014-0151-0 · Cited by 339 · see citing works
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Schwartz, S., & Correll, C. U. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.11.005 · Cited by 166 · see citing works
ADHD Treatments, Sleep, and Sleep Problems: Complex Associations
Stein, M. A., Weiss, M., & Hlavaty, L. (2012) · Neurotherapeutics · doi:10.1007/s13311-012-0130-0 · Cited by 165 · see citing works
Advances in understanding and treating ADHD
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- Authors
- Block, S. L., Kelsey, D., Coury, D., Lewis, D., Quintana, H., Sutton, V., Schuh, K., Allen, A. J., & Sumner, C.
- Affiliations
- Kentucky Pediatric Research, Bardstown, Kentucky,
- Eli Lilly (United States) (US)
- Nationwide Children's Hospital (US)
- Norfolk Public Schools (US)
- Louisiana State University Health Sciences Center New Orleans (US)
- Corresponding author
- Block, Stan L.
- Venue
- Clinical Pediatrics
- Publisher
- SAGE Publications
- Published
- 2009-05-06
- Volume
- 48
- Issue
- 7
- Pages
- 723-733
- ISSN
- 0009-9228 (ISSN-L)
- 1938-2707
- OpenAlex
- W2141637897
- Cited by
- 53
- References
- 11
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2020: 5 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 7 · 2014: 5 · 2013: 9 · 2012: 3
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- atomoxetine, attention deficit hyperactivity disorder, children with ADHD, once-daily dosing, adverse events, tolerability
- MeSH terms
- Atomoxetine Hydrochloride, Attention Deficit Disorder with Hyperactivity, Child, Double-Blind Method, Drug Administration Schedule, Female, Humans, Male, Propylamines, Time Factors, Treatment Outcome, Adrenergic Uptake Inhibitors
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